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Technical Considerations of Phosphorous-32 Bremsstrahlung SPECT Imaging after Radioembolization of Hepatic Tumors: A Clinical Assessment with a Review of Imaging Parameters.

Abstract
Background. Bremsstrahlung (BS) imaging during radioembolization (RE) confirms the deposition of radiotracer in hepatic/extrahepatic tumors. The aim of this study is to demonstrate (32)P images and to optimize the imaging parameters. Materials and Methods. Thirty-nine patients with variable types of hepatic tumors, treated with the intra-arterial injection of (32)P, were included. All patients underwent BS SPECT imaging 24-72 h after tracer administration, using low energy high resolution (LEHR) (18 patients) or medium energy general purpose (MEGP) (21 patients) collimators. A grading scale from 1 to 4 was used to express the compatibility of the (32)P images with those obtained from CT/MRI. Results. Although the image quality obtained with the MEGP collimator was visually and quantitatively better than with the LEHR (76% concordance score versus 71%, resp.), there was no statistically significant difference between them. Conclusion. The MEGP collimator is the first choice for BS SPECT imaging. However, if the collimator change is time consuming (as in a busy center) or an MEGP collimator is not available, the LEHR collimator could be practical with acceptable images, especially in a SPECT study. In addition, BS imaging is a useful method to confirm the proper distribution of radiotherapeutic agents and has good correlation with anatomical findings.
AuthorsElahe Pirayesh, Mahasti Amoui, Shahram Akhlaghpoor, Shahnaz Tolooee, Maryam Khorrami, Hossain Poorbeigi, Shahab Sheibani, Majid Assadi
JournalRadiology research and practice (Radiol Res Pract) Vol. 2014 Pg. 407158 ( 2014) ISSN: 2090-1941 [Print] Egypt
PMID24800073 (Publication Type: Journal Article)

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